Laboratory tests for measurement of von Willebrand factor show poor agreement among different centers: Results from the United Kingdom National External Quality Assessment Scheme for Blood Coagulation
Laboratory tests for measurement of von Willebrand factor show poor agreement among different centers: Results from the United Kingdom National External Quality Assessment Scheme for Blood Coagulation
复制标题
DOI：
10.1055/s-2006-947863
复制
发表时间：
2006-07-01
影响因子：
5.7
通讯作者：
Preston, Francis E.
中科院分区：
文献类型：
--
作者：
Kitchen, Steve;Jennings, Ion;Preston, Francis E.
认识到血管性血友病因子（vWF）检测在诊断血管性血友病（vWD）中的重要性，英国国家凝血外部质量评估计划定期分发用于测定vW：抗原（vWF：Ag）的样本。审查了2001年至2005年期间进行的10项单独调查的数据。其中包括来自200个不同中心的结果，其中55%在英国，其余来自其他国家。在调查期间，使用免疫电泳测定vWF：Ag几乎消失，并在很大程度上取代了乳胶凝集试验。对于大多数vWF：Ag技术，不同中心结果的变异系数（CV）相似于15 - 20%，对于基于荧光的测定，CV相似于7%。使用几种不同的技术测定vWF瑞斯托康辅助因子活性（vWF：RCo），所有这些技术均与中心间一致性差相关，CV为40 - 50%。几个中心计算了vWF：Ag/vWF：RCo的比值，但成功率各不相同。在来自1型vWD受试者的样本以及来自遗传学证实的2型vWD受试者的样本上获得与1型或2型vWD兼容的比率。总的来说，我们的数据表明，vWD的实验室检测仍然存在问题。新技术是否能持续提高精度还有待观察。
In recognition of the importance of von Willebrand factor (vWF) testing in the diagnosis of von Willebrand disease (vWD), the United Kingdom National External Quality Assessment Scheme for Blood Coagulation regularly distributes samples for determination of v W:antigen (vWF:Ag). Data from 10 separate surveys performed between 2001 and 2005 are reviewed. These include results from similar to 200 different centers, of which 55% are within the United Kingdom and the remainder are from other countries. During the period of the surveys, the use of immunoelectrophoresis for determination of vWF:Ag practically disappeared and was largely replaced by latex agglutination assays. The coefficient of variation (CV) of results in different centers was similar to 15 to 20% for most vWF:Ag techniques, with CVs of similar to 7% for a fluorescence-based assay. Several different techniques were used for determination of vWF ristocetin cofactor activity (vWF:RCo), all of which were associated with poor agreement among centers as indicated by CVs of 40 to 50%. Several centers calculated the ratio of vWF:Ag/vWF:RCo but with variable success. Ratios compatible with either type 1 or type 2 vWD were obtained on samples from subjects with type 1 vWD, as well as on samples from subjects with genetically confirmed type 2 vWD. Overall, our data show that laboratory testing for vWD remains problematic. It remains to be seen whether newer techniques will offer consistently improved precision.